Analysis Of Factors Affecting The Prognosis Of Patients With Liver Cirrhosis Based On Propensity Score Matchin

Objective: To explore the influence of esophageal and gastric varices bleeding(EGVB)on one-year mortality and influencing factors patients with liver cirrhosis,providing guidance for clinical follow-up and treatment for thin ese patients.Methods: This study selected liver cirrhosis patients who were admitted to the Affiliated Changsha Central Hospital,University of South China from January2015 to May 2021.The patients were divided into EGVB group and non-bleeding(control group)by the prevalence of EGVB at the first consultation.One-year routine follow-up was conducted with them until the date of death from liver cirrhosis or the termination follow-up day.Logistic regression analysis was conducted for screening the factors affecting one-year mortality.Furthermore,the covariates between the two groups were matched in a 1 ∶ 2 ratio using propensity score matching(PSM).Then,Logistic regression analyses were applied to identify and compare the influencing factors of one-year mortality in the groups.Results: Among the 812 patients enrolled,158(19.5%)were diagnosed with EGVB,and the other 654(80.5%)had no EGVB.The one-year mortality of the EGVB and control groups was 13.3%(21/158)and 13.9%(91/654),respectively,showing no significant difference(P>0.05).Before PSM,multivariate Logistic regression analysis showed that serum sodium [ OR=0.95,95%CI(0.90,0.99)] and albumin [ OR=0.95,95%CI(0.91,0.99)] were independent protective factors for one-year death in patients with cirrhosis(P<0.05),while age[ OR=1.04,95%CI(1.02,1.06)]and hepatic encephalopathy(grade Ⅲ or Ⅳ)[ OR=3.72,95%CI(1.21,11.37)]were independent risk factors for one-year mortality in patients with cirrhosis(P<0.05).After PSM,the one-year mortality was the same in EGVB group(n=145)and control group(n=290)[ 12.4%(18/145)vs 12.4%(36/290)],showing no significant difference(P>0.05).Moreover,blood urea nitrogen(BUN)[ OR=1.15,95%CI(1.02,1.29)] was an independent risk factor for one-year mortality in EGVB group(P<0.05),while age [ OR=1.09,95%CI(1.04,1.14)] and neutrophilto-lymphocyte ratio(NLR)[ OR=1.09,95%CI(1.00,1.18)]acted as independent risk factors for one-year mortality in the control group(P<0.05).Conclusion: 1、 EGVB had no obvious association with one-year mortality in liver cirrhosis patients.But there were considerable discrepancies in the risk factors affecting one-year mortality between the two groups.2、 The independent risk factors for the one-year mortality outcome in patients with cirrhosis were age and hepatic encephalopathy(grade Ⅲ or Ⅳ),the independent protective factors were albumin and serum sodium.3、 BUN was the independent risk factor for one-year mortality in the EGVB group,while age and NLR were independent risk factors for one-year mortality in the control group.